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Predictors of death in chronic Chagas cardiomyopathy patients with pacemaker

Giselle de Lima Peixoto1, Martino Martinelli Filho1, Sérgio Freitas de Siqueira1

  • 1Heart Institute (InCor), University of São Paulo Medical School, Brazil.

International Journal of Cardiology
|October 29, 2017
PubMed

Insights

Chronic Chagas cardiomyopathy patients with pacemakers face a high annual mortality rate. Advanced heart failure, renal disease, and specific ECG/echocardiogram findings predict poor prognosis in these patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Chronic Chagas cardiomyopathy (CCC) is a severe manifestation of Chagas disease, often presenting with conduction abnormalities and bradycardia.
  • Pacemakers are frequently required for bradycardia management in CCC patients.
  • Understanding mortality rates and predictors in this population is crucial for prognosis.

Purpose of the Study:

  • To determine the annual mortality rate in CCC patients who have pacemakers.
  • To identify independent predictors of death in this cohort.

Main Methods:

  • A single-center prospective cohort study included 396 CCC patients with pacemakers.
  • Patients were followed for at least 24 months, undergoing clinical, device, electrocardiographic, and echocardiographic assessments.
  • Multivariate logistic regression was used to identify predictors of death.

Main Results:

  • The annual mortality rate was 8.6% (65 deaths in 16.4% of patients over a median follow-up of 1.9 years).
  • Sudden death (33.8%) and heart failure (32.3%) were the leading causes of mortality.
  • Independent predictors of death included advanced heart failure functional class, renal disease, QRS duration ≥150ms, left atrial enlargement, and left ventricular ejection fraction ≤43%.

Conclusions:

  • CCC patients with pacemakers exhibit a high annual mortality rate.
  • Pacemaker-related variables were not found to be predictors of death.
  • Identifying independent predictors aids in stratifying risk and managing patients with poor prognosis.
Abstract

Keywords:
Chronic Chagas cardiomyopathyDeathPacemaker

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